Abdulla Susanne
Otto-von-Guericke University, Magdeburg, Germany.
Acta Anaesthesiol Belg. 2013;64(1):1-13.
Perioperative aspiration into the lungs is an infrequent but potentially serious cause of anesthesia-related morbidity and mortality. It is still a leading cause of death from pulmonary complications. Aspiration occurs in approximately three per 10.000 anesthetic procedures with higher incidences in special patient populations and emergency situations. Any patient with symptoms following aspiration that last for more than two hours in the recovery room should be admitted to an intensive care unit for further observation and therapy. This article reviews incidence, morbidity and mortality of perioperative aspiration as well as risk factors and preventive measures. Among preventive measures the use of drugs designed to increase gastric pH, recent developments in supraglottic airway devices and application of rapid sequence induction with cricoid pressure are discussed. Also, international fasting guidelines and clinical management following aspiration are provided.
围手术期肺部误吸是麻醉相关发病和死亡的一个罕见但潜在严重的原因。它仍然是肺部并发症导致死亡的主要原因。在每10000例麻醉手术中，约有3例发生误吸，在特殊患者群体和紧急情况下发生率更高。任何在恢复室中误吸后症状持续超过两小时的患者都应入住重症监护病房进行进一步观察和治疗。本文综述了围手术期误吸的发生率、发病率和死亡率，以及危险因素和预防措施。在预防措施方面，讨论了使用旨在提高胃内pH值的药物、声门上气道装置的最新进展以及环状软骨压迫下的快速顺序诱导的应用。此外，还提供了国际禁食指南和误吸后的临床管理方法。
